ArticleThe Kaohsiung journal of medical sciences2012
Fluconazole exposure rather than clonal spreading is correlated with the emergence of Candida glabrata with cross-resistance to triazole antifungal agents.
Article in The Kaohsiung journal of medical sciences, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Global prevalence and trends of fluconazole resistance in non-albicans Candida species: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- The airway mycobiome in chronic respiratory diseases: current advances and future frontiers.Journal of translational medicine · 2025Review
- Lung microbiome: new insights into the pathogenesis of respiratory diseases.Signal transduction and targeted therapy · 2024Review
- The impact of COVID-19 on antimicrobial prescription and drug resistance in fungi and bacteria.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2022Article
- Article
- Synthesis, Optimization, Antifungal Activity, Selectivity, and CYP51 Binding of New 2-Aryl-3-azolyl-1-indolyl-propan-2-ols.Pharmaceuticals (Basel, Switzerland) · 2020Article
- Clonal Spread of Candida glabrata Bloodstream Isolates and Fluconazole Resistance Affected by Prolonged Exposure: a 12-Year Single-Center Study in Belgium.Antimicrobial agents and chemotherapy · 2018Article
- Synergistic Antifungal Effect of Fluconazole Combined with Licofelone against ResistantFrontiers in microbiology · 2017Article
- Synergistic Effect of Fluconazole and Calcium Channel Blockers against Resistant Candida albicans.PloS one · 2016Article
- Nosocomial candidiasis in Rio de Janeiro State: Distribution and fluconazole susceptibility profile.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2015Article
- Components of the calcium-calcineurin signaling pathway in fungal cells and their potential as antifungal targets.Eukaryotic cell · 2015Review
- The lung mycobiome: an emerging field of the human respiratory microbiome.Frontiers in microbiology · 2015Article
- Epidemiology, species distribution and outcome of nosocomial Candida spp. bloodstream infection in Shanghai.BMC infectious diseases · 2014Article
- Surveillance of the prevalence, antibiotic susceptibility, and genotypic characterization of invasive candidiasis in a teaching hospital in China between 2006 to 2011.BMC infectious diseases · 2013Article
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4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The emergence of antifungal resistance in Candida species has raised concern in recent years, especially resistance toward triazole. Several newer triazole antifungal agents have been introduced which have a broader spectrum for fungal infections, such as voriconazole. However, cross-resistance among triazoles is a major concern with regard to their clinical application. Antifungal susceptibility was performed using E-test for 166 clinical isolates (29 blood and 137 nonblood isolates) in 2003 and 2004. We applied pulsed-field gel electrophoresis for genotyping. Ninety isolates of C. albicans, 47 isolates of C. tropicalis, 27 isolates of C. glabrata, and two isolates of C. krusei were included. All isolates were susceptible to amphotericin B. Eleven (40.7%) of the 27 C. glabrata had intermediate resistance to caspofungin. Forty-seven (28.3%) of the 166 isolates were not susceptible to fluconazole, including two C. albicans, 16 C. tropicalis, 27 C. glabrata, and two C. krusei isolates. All except seven of the C. glabrata isolates were susceptible to voriconazole. All the triazole drugs had a positive correlation among their minimum inhibitory concentrations (MICs). Fluconazole MIC was a good predictor for susceptibility to voriconazole, as determined using a receiver operating characteristic curve. Furthermore, a high diversity of pulsotypes for the 27 clinical isolates of C. glabrata was observed. Previous fluconazole exposure within 3 months was associated with reduced triazole susceptibility for C. glabrata. We demonstrated a significant positive correlation of MIC values among the four tested triazole drugs. No amphotericin B and caspofungin resistant isolates were found in this study. The cross-resistance to triazole among C. glabrata isolates was associated with previous fluconazole exposure as opposed to clonal spreading. Selection pressure due to fluconazole use may play a major role in triazole cross-resistance.
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